Inverted T waves in patient with Addisonian crisis
Firat Ozcan1, Ihsan Ustun, Dilek Berker
1Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Turkey.
Journal of the National Medical Association
|December 13, 2005
Summary
Addisonian crisis, a form of acute adrenocortical insufficiency, can mimic cardiac ischemia. This case highlights the importance of considering Addisonian crisis in patients with hypotension and ECG changes, even without cardiac history.
Area of Science:
- Endocrinology
- Cardiology
- Internal Medicine
Background:
- Addisonian crisis is acute adrenocortical insufficiency, often triggered by stress in patients with Addison's disease.
- Electrocardiographic (ECG) changes can occur in Addisonian crisis, potentially mimicking cardiac ischemia.
Observation:
- A 39-year-old female presented with Addisonian crisis.
- Her ECG showed ST depression and inverted T waves, despite normal cardiac enzymes and no history of heart disease.
Findings:
- Cardiac evaluations, including stress testing and echocardiography, were normal.
- The patient's presentation included hypotension and ischemic ECG changes.
Implications:
- Addisonian crisis should be considered in the differential diagnosis of hypotension with ischemic ECG changes, especially in the absence of coronary artery disease.
- This case emphasizes the need for a broad differential diagnosis in critical care settings.
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